December 1, 2004
By Sheree Russouw
ALL that Agnes Nkwana, 33, knows about Aids is that it kills. And that is probably the most vital message in the fight to curb the spread of the disease in South Africa.
"I don't know nothing about Aids, except that if I get it, it will kill me," says Nkwana as she washes her family's faded clothes outside their tiny shack in a dirty squatter camp in Ivory Park outside Johannesburg.
She stands to cradle her three-year-old son, clad in tattered clothes. Crusty food coats his young face. "I always tell my boyfriend to use a condom. But he doesn't want to, especially when he is drunk. I don't know if I am HIV-positive or not and I don't know where to go to find out."
The "shocking" lack of awareness about the disease is particularly pronounced in informal settlements like Ivory Park, where poorer residents are starved of information about the pandemic, says Meisie Lerutla, the City's Deputy Director of HIV/Aids.
"The people here don't have access to television and can't afford to buy a newspaper. Some have radios but when the batteries run out, they are left with nothing," she says.
"As the government, we must target informal settlements because people here still don't know about HIV/Aids. The reality is that they don't have access to information."
On Wednesday Lerutla joined about 200 of the City's HIV/Aids volunteers and officials, including Mayor Amos Masondo, who visited the homes of Ivory Park residents to educate them about the disease.
Their hands and pockets were filled with condoms, information pamphlets and stickers, which were handed out to residents. This week, the City Council dispatched 2900 volunteers, mostly young people, to raise awareness about the disease across Johannesburg as part of World Aids Day on December 1.
The City's volunteers are icons of "quality leadership", who are ready to go out into communities to do their jobs, says Masondo,
"We must not just work for one day a year - World Aids Day. We must ensure that this message of stopping HIV/Aids enjoys overtime. A lot more work needs to be done to fight the disease in the future," he says.
For volunteer and aspirant nurse Ntabiseng Lekhula, hope lies in Ivory Park's HIV-positive people who are informing their neighbours not only about the ravages of the disease but how they can survive it.
"The people here don't want to accept that they have the disease or that it exists. But there are many people who form HIV/Aids support groups and educate others about the disease because they don't want to get sick themselves," she says.
As Masondo distributed condoms and pamphlets to residents, he too found himself bombarded by questions.
"Have they found a cure for Aids?" one resident asked, clutching his pack of condoms. "What if the government lies about the expiry date on a condom?" asked another. And when, they all wondered, would there be jobs for them?
"Employment and HIV/Aids are our number one concerns," replied Masondo. "We have to work together to fight this disease…I remember when the ANC comrades came back from exile in the 1990s and we had our first meetings about Aids.
"We thought it was very far removed from us, that it was something that only happened in America. But it is a serious problem in South Africa today."
The sheer scale of the pandemic is heightened in townships like Ivory Park, where many residents speak of losing their children and partners to the disease.
Although the government would like to see more people on antiretroviral treatment - around 6000 people in Johannesburg are currently on Aids drugs - poverty often curtails the efficacy of the drugs, says Refik Bismilla, Director of the City's Health Department.
"You have to be highly disciplined to take the medicine - don't drink, don't smoke, eat a lot of fruit and vegetables and take the medicine every day at the same time. But it's difficult to keep to these standards in informal settlements. The people here are poor and some don't have a meal for days."
Jabu Shabalala-Rakosa, the City's new Deputy Director of Primary Health Care, refers to this as the "politics of the stomach". This, she says, sees women failing to negotiate the use of condoms in their households because their partners support them. In other instances they turn to "dangerous" sexual activities, like the phenomenon of "sugar daddies", to survive.
Women like Nkwana, she says, don't have the power to negotiate with their boyfriends to use a condom because the men are often the sole breadwinners.
"We give people condoms and counsel them about Aids, but we don't discuss the delicate policies of sex in the bedroom.
"These women go home to men who don't want to use a condom. We haven't given enough attention to the power struggles that exist within homes."
Bismilla says although there is a general increase in Aids awareness in Johannesburg, the City's campaign needs to be broadened and made more personal.
"We need to deepen the understanding of Aids and interact with people on a more substantive basis, like one-on-one. We need to talk to our people about the issues that affect them and about safe sex and staying faithful, instead of just giving them condoms and pamphlets about Aids."
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